The Effectiveness of Low-Vision Rehabilitation on Participation in Daily Living and Quality of Life
Purpose: To evaluate the effectiveness of a multidisciplinary low-vision rehabilitation program on quality of life evaluated by the Impact of Vision Impairment (IVI) instrument.
Methods: First-time referrals to low-vision clinics were assessed before and after rehabilitation (3-6 months). Rasch analysis was used to estimate the three IVI subscale and overall values on an interval scale. A mixed between-within subjects ANOVA was used to identify whether presenting visual acuity had an interaction effect with rehabilitation change. Cohen d values were used to estimate the magnitude of the change and the standardized response mean (SRM) procedure was selected to determine the clinical significance of the rehabilitationinduced changes.
Results: One hundred twenty-four women and 68 men (mean age, 80.3 years) completed the rehabilitation. Most had agerelated macular degeneration (62%, 119) and were moderately to severely vision impaired (<6/18; 78%, 149). After rehabilitation, significant improvements were recorded for the overall IVI score (P = 0.006) and two subscales: reading and accessing information and emotional well-being (P = 0.007 and 0.009, respectively). No significant improvement was found on the mobility and independence subscale (P = 0.07). The magnitude of the postintervention improvement was found to be relatively moderate (Cohen d = 0.17- 0.30) and clinically modest (SRM = 0.22 - 0.42).
Conclusions: Significant improvements in overall quality of life and two specific areas of daily living in people with low vision were found, although the magnitude and clinical significance of the rehabilitation-induced gains were modest. Further investigation in other models of low-vision rehabilitation is needed to optimize quality of life gains in people with low vision.
Invest Ophthalmol Vis Sci. 2007;48:1476-1482.
Ecosse L. Lamoureux,1 Julie F. Pallant,2 Konrad Pesudovs,3 Gwyn Rees,1 Jennifer B. Hassell,1 and Jill E. Keeffe1,1,4
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